New guidelines reflect changes in epilepsy drug choices

March 1, 2002

Pharmaceutical Representative

New expert consensus guidelines for the treatment of epilepsy have been published in the journal Epilepsy and Behavior.

New expert consensus guidelines for the treatment of epilepsy, including new options for women and older adults, have been published in the journal Epilepsy and Behavior (vol. 2, no. 6). The new guidelines contain two major changes: first, increased use of single antiepileptic drugs before turning to combination therapies; second, recognition of the need for special treatment strategies for groups such as women and older adults, who until recently have been overlooked in clinical studies.

"We are fortunate to have so many antiepileptic drugs today. But this also makes the selection and sequence of therapies more complex, especially for physicians who don't routinely see patients with epilepsy," said Martha Morrell, senior author of the guidelines.

For the first time, the new guidelines address how to integrate the full range of antiepileptic drugs - including newer therapies - into optimal treatment strategies, based on seizure type and individual patient needs.

According to Morrell, the use of single agents can help accomplish the goal of balancing the best degree of seizure control with the least likelihood of side effects that could impair a patient's ability to function and participate in routine activities.

The guidelines also reflect the distinct needs of specific patient populations, such as women of childbearing years and older adults. New research has demonstrated that many antiepileptic drugs can either compromise reproductive health for women or impair the cognitive ability of older patients, as well as causing dizziness and sedation in the latter group.

"Epilepsy cannot be treated with a 'one size fits all' approach," noted Steven Karceski, co-author of the guidelines. "The expert opinions reflected here underscore the need to tailor antiepileptic drug choices to individual patient needs." PR

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